Understanding empathy in autism spectrum disorder: the role of the insula and its connectivity. A literature review

Details

Supervisors

Liberati, Giulia ; Samson, Dana

Faculty

Faculté de psychologie, logopédie, sexologie et des sciences de la famille

Degree label

Master [120] en sciences psychologiques, à finalité spécialisée

Abstract

enEmpathy enables us to understand and respond to the experiences of others, yet the mechanisms underlying this ability remain complex. In Autism Spectrum Disorder (ASD), differences in social cognition and empathy have been widely documented, although their nature and underlying mechanisms are still debated. Some cerebral structures are already well studied in ASD, including the medial prefrontal cortex, the amygdala, the hippocampus, or the striatum (Lord et al., 2020). Yet insufficient attention has been given to the insula, a key region involved in interoception, emotional awareness, and the integration of bodily and socio-emotional information. Its role in processing one's own internal states and in responding to the emotional experiences of others makes it a particularly relevant structure for understanding individual differences in empathy in ASD. This thesis examines the question: How might alterations in the insula, including its connectivity, contribute to differences in empathy in ASD?  Through a critical review of the existing literature, this thesis brings together evidence on structural and functional alterations of the insula, and provides additional insights into the mechanisms surrounding the topic, as well as changes in its connectivity with broader networks involved in social cognition. The available evidence points towards a complex and heterogeneous relationship in which insular functioning may interact with individual differences in interoception, alexithymia, and the broader neural networks supporting empathy. These findings highlight the importance of moving beyond a generalized notion of an “empathy deficit” in autism and of considering the different mechanisms that may contribute to individual empathic profiles. Finally, this thesis identifies current gaps in the literature and discusses methodological and conceptual challenges that continue to limit our understanding.